Attributing inpatient care to diabetes : the case of Medicare for the elderly in Texas, 1995
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Attributing inpatient care to diabetes : the case of Medicare for the elderly in Texas, 1995
- Publication date
- 2000
- Topics
- Dissertations, Academic, Delivery of Health Care, Cost of Illness, Diabetes Mellitus, Hospitals, Hospitalization, Medicare, Aged, Medical care, Medical care, Cost of, Diabetes, Hospital utilization, Hospitals, Medicare, Older people
- Collection
- cms-reports; cmslibrary; fedlink; medicalheritagelibrary; americana
- Contributor
- Centers for Medicare & Medicaid Services Library
- Language
- English
Advisor: David C. Warner
"This project was supported by funding under the Dissertation Fellowship Program (grant no. 30-P-90725/6-01) of the Office of Research and Demonstrations at the Health Care Finance Administration (HCFA)."--p. iv
"August, 2000"
Includes bibliographical references (leaves 149-154)
Specific aims . This study estimated the accuracy of alternative numerator methods for attributing health care utilization and associated costs to diabetes by comparing findings from those methods with findings from a benchmark denominator method
Methods . Using Medicare's 1995 inpatient and enrollment databases for the elderly in Texas, the researcher developed alternative estimates of costs attributable to diabetes. Among alternative numerator methods were selection of all records having diabetes as a principal or secondary diagnosis, and a complex ICD-9-CM sorting routine as previously developed for study of diabetes costs in Texas. Findings from numerator methods were compared with those from a benchmark denominator method based on attributable risk and adapted from a study of national diabetes costs by the American Diabetes Association. This study applied age, gender and ethnicity specific estimates of diabetes prevalence taken from the 1987-94 National Health Interview Surveys to person-months of Medicare Part A, non-HMO enrollment for Texas in 1995. Outcome measures were number of persons identified as having diabetes using alternative definitions of the disease; and number of hospital stays, patient days, and costs using alternative methods for attributing care and costs to diabetes. Cost estimates were based on Medicare payments plus deductibles, co-pays and third party payments
Findings . Numerator methods for attributing costs to diabetes produced findings quite different than those from the benchmark denominator method. When attribution was based on diabetes as principal or secondary diagnosis, the resulting estimates were significantly higher than those obtained from the denominator method. The more complex sorting routine produced estimates near the lower boundary for the confidence interval associated with estimates from the benchmark method
Conclusions . Numerator methods employed by previous researchers poorly estimate the costs of diabetes. While crude mathematical adjustment can be made to the respective numerator approaches, a more useful strategy would be to refine the complex sorting routine to include more hospitalizations. This report recommends approaches to improving methods previously employed in study of diabetes costs
"This project was supported by funding under the Dissertation Fellowship Program (grant no. 30-P-90725/6-01) of the Office of Research and Demonstrations at the Health Care Finance Administration (HCFA)."--p. iv
"August, 2000"
Includes bibliographical references (leaves 149-154)
Specific aims . This study estimated the accuracy of alternative numerator methods for attributing health care utilization and associated costs to diabetes by comparing findings from those methods with findings from a benchmark denominator method
Methods . Using Medicare's 1995 inpatient and enrollment databases for the elderly in Texas, the researcher developed alternative estimates of costs attributable to diabetes. Among alternative numerator methods were selection of all records having diabetes as a principal or secondary diagnosis, and a complex ICD-9-CM sorting routine as previously developed for study of diabetes costs in Texas. Findings from numerator methods were compared with those from a benchmark denominator method based on attributable risk and adapted from a study of national diabetes costs by the American Diabetes Association. This study applied age, gender and ethnicity specific estimates of diabetes prevalence taken from the 1987-94 National Health Interview Surveys to person-months of Medicare Part A, non-HMO enrollment for Texas in 1995. Outcome measures were number of persons identified as having diabetes using alternative definitions of the disease; and number of hospital stays, patient days, and costs using alternative methods for attributing care and costs to diabetes. Cost estimates were based on Medicare payments plus deductibles, co-pays and third party payments
Findings . Numerator methods for attributing costs to diabetes produced findings quite different than those from the benchmark denominator method. When attribution was based on diabetes as principal or secondary diagnosis, the resulting estimates were significantly higher than those obtained from the denominator method. The more complex sorting routine produced estimates near the lower boundary for the confidence interval associated with estimates from the benchmark method
Conclusions . Numerator methods employed by previous researchers poorly estimate the costs of diabetes. While crude mathematical adjustment can be made to the respective numerator approaches, a more useful strategy would be to refine the complex sorting routine to include more hospitalizations. This report recommends approaches to improving methods previously employed in study of diabetes costs
- Addeddate
- 2013-07-09 18:58:55
- Boxid
- 30-P-90725/6
- External-identifier
- urn:oclc:record:1040017815
- Foldoutcount
- 0
- Identifier
- attributinginpat00mcca
- Identifier-ark
- ark:/13960/t4fn2vk06
- Identifier_bib
- 30-P-90725/6
- Isbn
- 0599922923
9780599922921
- Ocr_converted
- abbyy-to-hocr 1.1.37
- Ocr_module_version
- 0.0.21
- Page-progression
- lr
- Page_number_confidence
- 88
- Page_number_module_version
- 1.0.3
- Pages
- 165
- Possible copyright status
- The Centers for Medicare & Medicaid Services Library is unaware of any copyright restrictions for this item.
- Scandate
- 20130719193944
- Scanner
- sheetfed01.capitolhill.archive.org
- Scanningcenter
- capitolhill
- Source
- special
- Worldcat (source edition)
- 45764235
- Year
- 2000
- Full catalog record
- MARCXML
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